Purpose: To evaluate the clinical management and outcomes of renal cell carcinoma recurrence at a single academic institution. Materials and Methods: A prospectively maintained, Institutional Review Board-approved database of patients treated for renal cell carcinoma (n=781) was reviewed to identify patients with confirmed local or metastatic recurrence between 2013-2023. Results: A total of 12 patients were identified with renal cell carcinoma recurrence. Initial management of renal cell carcinoma was partial nephrectomy (50%), radical nephrectomy (41.7%), and percutaneous ablation (8.3%). Median follow up was 37.4 (5 – 143) months. Median time to recurrence was shortest amongst patients initially treated by radical nephrectomy (6.0 months). Five patients recurred with distant, multiple metastases and were referred to medical oncology without surgical reintervention. A single patient recurred with localized, well-defined nodal metastasis which was successfully managed by robotic retroperitoneal lymph node dissection. Five patients underwent repeat robotic partial nephrectomy or completion nephrectomy. All cases were technically successful without major complications. Average length of hospitalization was one day. Median creatinine preoperatively was 1.21 mg/dl (0.75-1.79), and post-reintervention the median creatinine was 1.42 mg/dl (1-2.7). Conclusions: An algorithm for management of local recurrence includes review of initial pathology report, increased frequency of imaging in the context of positive margin, diligent compliance with surveillance, percutaneous biopsy to confirm histological evidence of recurrence and counseling patient as to risks of chronic renal failure, conversion to completion radical nephrectomy, and a multidisciplinary approach with medical oncology